This Is the Absolute Worst Place on Earth to Spend Your Bitcoins

Most people suffering from irregular bowel movements visit their doctor and get some expert advice. But if that requires too much time or money, there are other options. Like, say, paying some random stranger a fraction of a Bitcoin to tell you what’s wrong.

Thanks to a new website called CoinMD, you can upload a photo of your latest bowel movement to the internet — together with a detailed description of your ongoing troubles — and obtain advice from an anonymous group of people who swear they’re doctors. If you like what you hear, you pay them in bitcoin, the world’s most popular digital currency. Or not. You can just take the advice for free. That’s what this guy did after uploading a picture of his stool to the new service.

Recently launched — and touted on Reddit — CoinMD combines three extremely hot internet trends: digital currency, crowdsourcing, and online healthcare. It’s a rather clever service — and it’s absolutely frightening. This is yet another reason to remember that, while the internet promises so much, it can also go horribly wrong.

“Personally, I think the idea is a genius one,” says Dr. Iltifat Husain, the founder and editor-in-chief of iMedicalApps, when asked about CoinMD, pointing out that such a service could tap into the expertise of countless residents in training — students hungry for some extra money. Husain, who is not involved with CoinMD, believes it could actually be useful for people with common medical conditions. But this comes with a caveat. “I would never recommend this site to a patient,” he says, “because it’s not done right.”

The site’s pool of so-called doctors is anonymous for a reason. It can probably draw on the expertise of students, but no legitimate licensed physician would ever participate. They would risk losing their license. Indeed, the site doesn’t have a clearly defined policy for tracking physicians or vetting their credentials. Husain calls it “terrifying.”

What’s more, CoinMD doesn’t mention the risks of misdiagnosis or misleading information, and according to Husain, the chance of receiving such bad info is “tremendous.”

The site echoes existing services. JustAnswer.com claims to have doctors, nurses, and vets just a click away. Forums on Yahoo Answers and WebMD’s Symptom Checker offer free health-related information, though it steers clear of suggesting this advice comes directly from doctors. None of them is worth more than a passing glance.

Part of the problem is that, in order to legally practice their profession, doctors need to meet certain criteria. This involves everything from state-issued licenses and malpractice insurance to board certification, and most sites can’t easily meet these requirements. Not that doctors would come to those sites anyway. Those docs who use tele-medicine services will often limit the amount of advice they give, depending on the platform. And on services like HealthTap, which provides personalized nugget-sized answers to medical queries, patients might not get as much information as when using a full-fledged consult service like Teledoc or Ameridoc. It’s all in the name of providing good care — and avoiding lawsuits.

It’s just another form of recreation on the internet, but I’m afraid some people might take it more seriously and that could be dangerous.

— Paul Abramson

CoinMD founder Jason Pierce set up shop thinking that if you strip away identity — and the threat of medical malpractice lawsuits — a crowdsourced medical site could flourish. But this dependence on anonymity is a problem in its own right. Jason Pierce, it turns out, is not his real name, and when we asked to speak to him by phone, he declined. If you remain anonymous, it’s hard to engender trust.

Pierce also declines to identify his partner in the venture, who he claims is a doctor, but he insists this isn’t a problem. “No one needs to know, for example, who Satoshi is. They can read his code and decide whether it’s good or bad,” Pierce says, referring to the anonymous founder of bitcoin. “We do believe in free market, so if the market decides it’s not a good idea — then be it.”

You won’t get an argument from us there.

So far, according to Pierce, less than one bitcoin has been exchanged on the site and roughly 13 “doctors” have signed up and offered up advice on such topics as “a strange bumb on my wrist,” “testicle ultrasound,” high blood pressure,” and “peripheral neuropathy.” You also find a response to “I have had an on and off cough and Hourseness for the last 2 weeks,” a query that also appeared word for word on Yahoo! Answers.

The responses are for the most part generic. Some suggest that the patient schedule an appointment with an actual doctor. Others are a bit more disturbing, like the one that advises someone to wash his recurring case of penile irritation with a “non-aggressive detergent” (NSFW). If that didn’t work, wrote a “doctor” calling himself “erre,” it might be smart to see a specialist.

This is the same doctor who weighed in on that stool photo. Neither his penile advice nor the bowel movement recommendation received a bitcoin payment.

“I think this is for entertainment value only,” says Paul Abramson, a bitcoiner and founder of My Doctor Medical Group in San Francisco. “It’s just another form of recreation on the internet, but I’m afraid some people might take it more seriously and that could be dangerous.”